Considerable number of patients with metastatic urothelial carcinoma develop bone metastases. Immunecheckpoint inhibitors are approved, but their efficacy on bone metastasis has not been investigated. Data on 208 patients, treated with immunotherapy for advanced disease, were collected. Patients treated with immunotherapy for bone metastasis have a dismal prognosis compared to patients without bone involvement in terms of overall and progression-free survival.Background: Considerable numbers of patients with metastatic urothelial carcinoma (mUC) develop bone metastases (BoM). Their impact on the efficacy of immune-checkpoint inhibitors (ICIs) is not yet investigated. Methods: Between July 2014 and August 2020 data on pts treated with single-agent ICIs after failure of at least 1 previous line of chemotherapy for advanced disease, were retrospectively collected across 14 Italian centers. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method. Cox regression analysis was performed evaluating potential prognostic factors for OS and PFS. Each factor was evaluated in univariable (UVA) and multivariable analysis (MVA). Results: A total of 208 evaluable patients treated with ICIs were identified, including 122 (59%) without BoM (BoM-) and 86 (41%) with bone metastases (BoM+). After a median follow-up of 22.3 months, BoM+ patients showed shorter OS (median 3.9 vs 78 months, HR 1.59 [95%CI, 1.15-2.20], P = .005) and shorter PFS (median 2.0 vs 2.6 months, HR 1.76 [95%CI, 1.31-2.37], P < .001). Probability of being alive was 62% vs 40% after 6 months, 38% vs 23% after 1 year and 24% vs 13% after 2 years, in BoM- and BoM+ respectively. Within each Bellmunt score, OS and PFS of BoM+ patients were shorter. Both presence of BoM and higher Bellmunt risk score were significantly associated with shorter OS and PFS in UVA and MVA. Conclusion: Patients treated with single-agent ICIs for BoM+ mUC have a dismal prognosis compared to BoM-. Further research is needed to understand the mechanism behind these outcomes. (C) 2021 Elsevier Inc. All rights reserved.

Role of Bone Metastases in Patients Receiving Immunotherapy for Pre-Treated Urothelial Carcinoma: The Multicentre, Retrospective Meet-URO-1 Bone Study / Raggi, Daniele; Giannatempo, Patrizia; Marandino, Laura; Pierantoni, Francesco; Maruzzo, Marco; Lipari, Helga; Banna, Giuseppe L; De Giorgi, Ugo; Casadei, Chiara; Naglieri, Emanuele; Buti, Sebastiano; Bersanelli, Melissa; Stellato, Marco; Santini, Daniele; Vignani, Francesca; Roviello, Giandomenico; Veccia, Antonello; Caffo, Orazio; Losanno, Tania; Calabrò, Fabrizio; Mucciarini, Claudia; Pignata, Sandro; Necchi, Andrea; Maio, Massimo Di. - In: CLINICAL GENITOURINARY CANCER. - ISSN 1558-7673. - STAMPA. - 20:(2022), pp. 155-164. [10.1016/j.clgc.2021.12.008]

Role of Bone Metastases in Patients Receiving Immunotherapy for Pre-Treated Urothelial Carcinoma: The Multicentre, Retrospective Meet-URO-1 Bone Study

Roviello, Giandomenico;
2022

Abstract

Considerable number of patients with metastatic urothelial carcinoma develop bone metastases. Immunecheckpoint inhibitors are approved, but their efficacy on bone metastasis has not been investigated. Data on 208 patients, treated with immunotherapy for advanced disease, were collected. Patients treated with immunotherapy for bone metastasis have a dismal prognosis compared to patients without bone involvement in terms of overall and progression-free survival.Background: Considerable numbers of patients with metastatic urothelial carcinoma (mUC) develop bone metastases (BoM). Their impact on the efficacy of immune-checkpoint inhibitors (ICIs) is not yet investigated. Methods: Between July 2014 and August 2020 data on pts treated with single-agent ICIs after failure of at least 1 previous line of chemotherapy for advanced disease, were retrospectively collected across 14 Italian centers. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method. Cox regression analysis was performed evaluating potential prognostic factors for OS and PFS. Each factor was evaluated in univariable (UVA) and multivariable analysis (MVA). Results: A total of 208 evaluable patients treated with ICIs were identified, including 122 (59%) without BoM (BoM-) and 86 (41%) with bone metastases (BoM+). After a median follow-up of 22.3 months, BoM+ patients showed shorter OS (median 3.9 vs 78 months, HR 1.59 [95%CI, 1.15-2.20], P = .005) and shorter PFS (median 2.0 vs 2.6 months, HR 1.76 [95%CI, 1.31-2.37], P < .001). Probability of being alive was 62% vs 40% after 6 months, 38% vs 23% after 1 year and 24% vs 13% after 2 years, in BoM- and BoM+ respectively. Within each Bellmunt score, OS and PFS of BoM+ patients were shorter. Both presence of BoM and higher Bellmunt risk score were significantly associated with shorter OS and PFS in UVA and MVA. Conclusion: Patients treated with single-agent ICIs for BoM+ mUC have a dismal prognosis compared to BoM-. Further research is needed to understand the mechanism behind these outcomes. (C) 2021 Elsevier Inc. All rights reserved.
2022
20
155
164
Raggi, Daniele; Giannatempo, Patrizia; Marandino, Laura; Pierantoni, Francesco; Maruzzo, Marco; Lipari, Helga; Banna, Giuseppe L; De Giorgi, Ugo; Casadei, Chiara; Naglieri, Emanuele; Buti, Sebastiano; Bersanelli, Melissa; Stellato, Marco; Santini, Daniele; Vignani, Francesca; Roviello, Giandomenico; Veccia, Antonello; Caffo, Orazio; Losanno, Tania; Calabrò, Fabrizio; Mucciarini, Claudia; Pignata, Sandro; Necchi, Andrea; Maio, Massimo Di
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1295542
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